17.8 CNS Tumors

Question 1

How do metastatic CNS tumors present?

Answer 1

Multiple well-circumscribed lesion

Question 2

What are the cancers that metastasize to the brain?

Answer 2

Lung, breast and kidney cancer

Question 3

Do primary CNS tumors often metastasize?

Answer 3

No

Question 4

What is the most common CNS tumor in adults?

Answer 4

Glioblastoma Multiforme

Question 5

Where do tumors in adults tend to occur?

Answer 5

Above the tentorium

Question 6

Where do tumors in children tend to occur?

Answer 6

Beneath the tentorium

Question 7

Glioblastoma Multiforme (GBM)

Answer 7

Malignant high-grade tumor of astrocytes

Question 8

What is an important feature of GBM?

Answer 8

It will cross the corpus callosum

Question 9

What are some histological features of GBM?

Answer 9

Necrosis with pseudo-palisading cells and endothelial cell proliferation

Question 10

Meningioma

Answer 10

Most common benign tumor and is made of arachnoid cells

Question 11

What gender is meningioma seen more often in?

Answer 11

Females

Question 12

What symptom can meningiomas present with?

Answer 12

Seizures - mass that presses on the cortex

Question 13

What is the histologic feature of meningioma?

Answer 13

Whorled-cells

Question 14

Schwannoma

Answer 14

Benign tumor of Schwann cells that involves the cranial/spinal nerves

Question 15

What is a very common position for Schwannoma?

Answer 15

Cerobellar Pontine Angle and commonly involves CN VIII

Question 16

What marker is positive in Schewannomas?

Answer 16

S100

Question 17

With what are bilateral Schwannomas seen?

Answer 17

Neurofibromatosis Type 2

Question 18

Oligodendroglioma

Answer 18

Malignant tumor of oligodendrocytes that usually involves the frontal lobe and is a calcified tumor in the white matter

Question 19

What can oligodendroglioma present with?

Answer 19

Seizures

Question 20

What is the most common CNS tumor in children?

Answer 20

Pilocytic Astrocytoma

Question 21

Pilocytic Astrocytoma

Answer 21

Benign tumor of astrocytes that usually arises in the cerebellum

Question 22

What is seen on imaging of Pilocytic Astrocytoma?

Answer 22

Cyst with a neural nodule

Question 23

What is seen on histology of Pilocytic Astrocytoma?

Answer 23

Astrocytes with thick eosinophilic processes - Rosenthal fibers

Question 24

Medulloblastoma

Answer 24

Malignant tumor derived from granular cells of the cerebellum - neuroectodermal tissue - and is usually found in children

Question 25

What is seen on histology of medulloblastoma?

Answer 25

Small round blue cells with Homer-Wright rosettes that may or may not be present

Question 26

What is the prognosis of medulloblastoma?

Answer 26

Poor prognosis and the tumor grows rapidly, spreading with the CSF

Question 27

Ependymoma

Answer 27

Malignant tumor of the ependymal cells that is usually seen in children

Question 28

What area are ependymomas typically found?

Answer 28

4th ventricle - may present with hydrocephalus

Question 29

Craniopharyngioma

Answer 29

Benign tumor from epithelial remnants of Rathke’s pouch that presents as a supratentorial mass in children or young adults

Question 30

What can craniopharyngioma lead to?

Answer 30

Compression of the optic chiasm can lead to bitemporal hemianopia